When baby moves out of the vaginal opening, the stretched skin can tear easily. Natural tears are common during childbirth and tend to heal just as quickly as surgical cuts or episiotomies. There are four degrees of vaginal tearing during pregnancy:
- First Degree Vaginal Tearing – The least painful of all the vaginal tears is the first degree tear. Only the skin around the vagina is affected and tears may be less than one half inch in length. While there is typically some pain associated with the tear during urination, the tear will heal within a few weeks.
- Second Degree Vaginal Tearing – When vaginal tears reach the second degree, vaginal tissue and perineal muscles are affected. Stitches are often required to close the wound. The length of the tear can be one inch or longer. Most second degree vaginal tears will heal in a few weeks.
- Third Degree Vaginal Tearing – Similar to a second degree vaginal tear where tearing involves vaginal tissue and perineal muscles. In addition to these tissues and muscles being torn, the anal sphincter is also torn. Stitches are required to close the wound and healing time is extended to six weeks or more. Surgical repair of the torn muscles may be required.
- Fourth Degree Vaginal Tearing – The worst case of vaginal tearing involves vaginal tissues, perineal muscles, anal sphincter muscles and the rectum. Surgical repair of the tear is required for healing to begin. Women may require additional surgery to treat fecal incontinence. Rectal tearing increases the risk of infection so it is important to follow an approved cleansing regime very strictly during the healing process. After surgery, the wound will take six to eight weeks to heal.